Association between the lactate dehydrogenase-to-albumin ratio and prognosis in ICU sepsis-induced coagulopathy patients.

BACKGROUND

Sepsis-induced coagulopathy (SIC) is a severe complication of sepsis with high mortality. The lactate dehydrogenase-to-albumin ratio (LAR), a composite marker of cell injury and inflammation, is associated with sepsis prognosis, but its role in SIC remains unclear.

RESEARCH DESIGN AND

METHODS

Data from 1,500 SIC patients in the Medical Information Mart for Intensive Care database were used. The primary outcome was 30-day all-cause mortality and the secondary outcome was 90-day mortality. Kaplan-Meier curves, Cox regression, restricted cubic splines, and subgroup analyses were used.

RESULTS

Compared with the low-LAR group, medium- and high-LAR groups had higher 30- and 90-day mortality rates (p < 0.001). The fully adjusted Cox model showed positive correlations of ln(LAR) with 30-day (HR = 1.17, 95% CI: 1.03-1.31, p = 0.013) and 90-day mortality rates (HR = 1.17, 95% CI: 1.04-1.30, p = 0.007). The relationship between ln(LAR) and 30-day mortality rate was nonlinear (P-non-linear = 0.007), with an inflection point at 4.57. An interaction was observed for dobutamine therapy (P-interaction = 0.03).

CONCLUSIONS

LAR is associated with poor prognosis in patients with SIC, especially once ln(LAR) surpasses 4.57.